The Shifting Trends in Nursing: Experts Say Advanced Training Is Way of Future

By Phillip, Mary-Christine | Black Issues in Higher Education, December 15, 1994 | Go to article overview

The Shifting Trends in Nursing: Experts Say Advanced Training Is Way of Future


Phillip, Mary-Christine, Black Issues in Higher Education


The Shifting Trends In Nursing: Experts Say Advanced Training Is Way of. Future

by Mary-Christine Phillip

A rapidly aging population coupled with a wider use of out-of-hospital care and expanding community health services are contributing to a shortage of registered nurses that experts say will continue into the 21st century.

Although hospital closings and restructurings will reduce the demand for some patient care, the need for nurses in other areas outside the hospital -- health maintenance organizations, primary care, community health programs, home health care, etc. -- will continue to climb, forcing those who choose nursing as a profession to be highly skilled, educators say.

"Education and training will be tremendous challenges for many schools that offer nursing programs," says Marjorie Johnson, dean of the School of Nursing and Allied Health at Tuskegee University.

"The question is whether many of us, particularly those in rural areas, will be able to meet those challenges."

Skill Levels Questioned

The need for a highly skilled workforce is once again raising the question of whether community colleges or four-year institutions are better prepared to train nurses for the future.

With more than four times as many registered nurses in the United States as physicians, nurses deliver an extended array of health-care services. These include primary and preventative care by nurses with advanced training, as well as independent nurse practitioners in areas of pediatrics, family health, women's health and gerontological care.

Nurses also are trained to provide prenatal care as certified nurse-midwives and to serve as anesthetists. Specialties have been developed in cardiac care, oncology, neonatal, neurological, obstetric-gynecologic services and other advanced clinical practice areas.

Registered nurses receive their education either through a four-year bachelor of science in nursing (BSN) program; a two-year community college program in which they receive an associate's degree in nursing; or a three-year, hospital-based training program, under which graduates receive hospital diplomas.

Associate's Degrees Obsolete?

Officials at four-year institutions -- which offer the BSN degree -- say it's a matter of time before the associate's-degree nursing programs offered by community colleges are obsolete. For their part, officials at the community colleges say they are in step with the times and they are restructuring their curricula to place more emphasis on areas where the greatest needs will arise.

"In the future, and it's closer than we think, there are going to be fewer hospital beds in use. Already we are seeing that. And those who are being trained for hospital work are at the community colleges. Those who are trained at four-year institutions can do what two-year graduates do and more. Associate's-degree programs train students to offer the basic care. Four-year institutions offer much more," says Mary Mundinger, dean of the school of nursing at Columbia University.

Columbia runs one of the largest nursing programs in the country, offering degrees from BSN all the way up to doctoral preparation. Mundinger says, "In the future, associate's degrees in nursing will be out of date. I'm not sure people at community colleges are looking at the fact that their graduates will have a hard time getting jobs if they keep doing things the way they are doing."

Professional Concerns

Carole Caresio-Haas, president of the National Organization for Associate Degree Nursing, says that "to keep pace with the changing health care scene, community-college educators are restructuring their curricula to place more emphasis on community needs, home health care, clinics and wellness centers. They are also enhancing teaching of management concepts in class and in clinical settings."

Haas, who is also director of nursing at Illinois Valley Community College, says that the "restructuring and redefining of educational programs and roles is nothing new for associate's-degree programs. …

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